3 CNOs on how the ACA changed their jobs

The Affordable Care Act changed all aspects of the healthcare industry, forcing leaders of all stripes to adapt to remain effective, and hospital and health system nursing executives are no exception. "A chief nurse, in order for us to stay relevant…has to evolve," said Nancy Gaden, DNP, RN, senior vice president and CNO of Boston Medical Center.

Dr. Gaden shared her thoughts on how the ACA has changed CNOs' jobs during a panel at the Becker's Hospital Review 7th Annual Meeting on April 28 in Chicago. Joining her on the panel were Gemma Rama-Banaag, RN, CNO of Paradise Valley Hospital in National City, Calif., and Catherine Whelchel, RN, former CNO of Spartanburg (S.C.) Regional Medical Center and current clinical content and quality leader for McKesson Technology Solutions.

Most of the evolution focused around data analysis and interpretation, panelists said. "I think the chief nurse today, what we're seeing is a real need to understand the data analysis," Ms. Whelchel said. "Not just the data, you have so much data, but understanding how to make it meaningful and getting that information to the front lines."

Ms. Rama-Banaag echoed similar concerns around data. "Data management is [a] real key," she said. "Hospital-acquired conditions and infections are all data and, when converted into information, can be very powerful."

The ACA also helped spark the industrywide move toward population health management, which provides nurse executives a unique opportunity to leverage their knowledge and gain influence in their organizations.

"A lot of other leaders in the organization [are] thinking about stuff that used to be uniquely ours" when it comes to managing the health of a population, Dr. Gaden said.

For instance, CNOs may be one of the only members of the C-suite or leadership team that had experience on the front-lines, directly caring for patients, and this perspective has become even more valuable in the post-ACA world.

"In a system that's evolving toward population health, there's a big role for the nurse leader, and it could take off without us if we're not really thinking about [it] and [being] careful," Dr. Gaden added.

Ms. Whelchel also advocated for nurse executives speaking up and offering their unique perspective more. "I do think the CNO has the heart of the patient at the center of that boardroom table, and I think that gives the opportunity to help really drive decisions in that way," she said.

If CNOs can harness this time of disruption to grow their influence, it can benefit the industry and patient care in the long run.

"I really do see nursing being more involved," said Ms. Rama-Banaag. "If you ask me, I really would like to see more nurses getting to the right table, the table where big decisions are made. I think we can bring a lot of value and a lot of meaning…I don't believe there are enough nursing voices at those tables. That's my wish."

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